Evaluation of TRIPSE

Name: MB

Provisional Hypotheses/Explanations (10): 6.8

Further Explorations/ Proposed Studies (10): 7

Re-Assessment/Synthesis (10): 7

Total (30): 20.8

Comments:

You gave 4 possible explanations. These related to the presence of different diets and traditional medicines as well as variability in the virulence of the microfilarial strains as well as proximity to the river. You noted that the alteration in diets could produce differential activation of enzymes.

Further approaches suggested included measurement of drug metabolites in urine and blood; a detailed survey of products consumed, measurement of water samples and re-assessment of microfilarial load. At this stage you noted that the standard dose of drug given may not have been the appropriate one for each of the villages.

The proposed explanations were reasonable though limited. You ignored the information concerning the Canadian team. Further you did not consider a whole set of explanations based on inadequate reporting, misclassification of adverse events etc.